For those who have atrial fibrillation (AFib), you’ve probably heard about the increased risk of stroke and the role of blood thinners in prevention. While blood-thinning medications are highly effective, they come with challenges, including daily use, lifestyle restrictions, and the possibility of bleeding complications. The Watchman™ procedure offers an alternative for patients who want lasting protection without relying on medication long-term.
What Is the Watchman Procedure?
The Watchman procedure is a minimally invasive treatment designed to reduce stroke risk in people with AFib not caused by a heart valve problem. Most strokes in AFib patients are linked to blood clots that form in a small pouch of the heart called the left atrial appendage. During the Watchman procedure, doctors close off this pouch with a tiny implant, preventing clots from entering the bloodstream.
The procedure is FDA-approved and has been performed in thousands of patients worldwide. It is a valuable option for those who need stroke protection but face difficulties with long-term anticoagulant use.
Who Is a Candidate for the Watchman Procedure?
Not every AFib patient is a candidate for Watchman, but for the right individuals, it can be life-changing. Doctors weigh several factors before making a recommendation, including stroke risk, bleeding history, and quality of life.
Who May Qualify
Patients with non-valvular AFib who have an elevated stroke risk and one or more reasons not to stay on long-term anticoagulation, such as:
- Low platelet count with increased bleeding risk
- Recurrent bleeding (e.g., gastrointestinal, genitourinary, or respiratory)
- History of severe bleeding, including intracranial hemorrhage
- High fall risk, including prior falls
- Poor tolerance or adherence to anticoagulation (side effects, interactions, or barriers to consistent use)
- A strong indication for combined dual antiplatelet + anticoagulant therapy, where bleeding risk would be excessive
Short-Term Therapy Requirement
Candidates should be able to tolerate short-term antithrombotic therapy after the procedure (typically a period of dual antiplatelet therapy or anticoagulation as directed by the cardiologist).
Who May Not Be Suitable
Patients who require ongoing anticoagulation for other reasons—e.g., an implanted mechanical heart valve—are generally not candidates for Watchman.
Watchman Procedure for AFib Patients
Patients who benefit most typically have non-valvular AFib, an elevated stroke risk, and a contraindication or intolerance to long-term anticoagulation (for example, prior bleeding, high fall risk, or low platelets). For these individuals, the Watchman offers a lasting way to protect against clot-related strokes while also reducing the side effects and lifestyle limitations that come with daily anticoagulation.
Watchman Procedure Age Limit
There is no strict age cutoff for the Watchman procedure. Instead, doctors like to consider whether the potential benefits outweigh the risks. Older patients may be good candidates because the device reduces their reliance on daily blood thinners, which can become more dangerous with age.
This assessment includes the same eligibility factors noted above (bleeding history, fall risk, platelet count, and ability to take short-term antithrombotic therapy after implant).
Watchman Procedure for Elderly Patients
Elderly patients are often considered for Watchman if they have a history of falls, bleeding problems, or medical conditions that make blood thinner use unsafe. For many, the procedure helps lower the chances of stroke while avoiding complications from anticoagulation over time.
Ultimately, candidacy is individualized. A cardiologist will review your health, lifestyle, and medical history before deciding if Watchman is the right fit.
Watchman Procedure vs. Other Heart Procedures
Several other procedures are used to lower stroke risk in AFib patients, and each has its own advantages.
Amulet Procedure vs. Watchman
Both the Amulet and Watchman devices are designed to seal the left atrial appendage. The Amulet differs slightly in shape and how it is delivered, but the purpose remains the same: preventing clots from leaving the heart.
Maze Procedure vs. Watchman
The Maze procedure treats AFib itself by creating scar tissue that blocks abnormal electrical signals in the heart. Unlike Watchman, it is more invasive and is often done during open-heart surgery.
Lariat Procedure vs. Watchman
The Lariat procedure uses a lasso-like suture to close off the left atrial appendage rather than implanting a device. While it was once more common, it is now performed less frequently compared with Watchman.
Your cardiologist will guide you through the pros and cons of each option based on your health, age, and treatment goals.
Recovery After the Watchman Procedure
Because Watchman is minimally invasive, recovery is usually quick and manageable.
Recovery Time for the Watchman Procedure
Most patients spend one night in the hospital for observation and go home the following day. Some soreness or fatigue is normal, but many people feel significantly better within a few days. Full recovery usually takes about a week.
Restrictions After the Watchman Procedure
Doctors generally recommend avoiding heavy lifting, driving, or strenuous activity for several days. It’s important to continue caring for the small catheter insertion to prevent infection. Patients receive specific instructions before discharge.
Exercise After the Watchman Procedure
Light walking is often encouraged soon after the procedure to aid circulation and lower healing time. More vigorous exercise should be postponed until a cardiologist confirms it is safe. Most patients return to normal activity within one to two weeks.
Benefits of the Watchman Procedure
The Watchman procedure provides several important benefits for AFib patients:
- Reduced risk of stroke without lifelong blood thinner use
- Lower chance of bleeding complications compared with anticoagulants
- Better quality of life and more independence in daily routines
- Proven safety and success rates in large clinical trials
Patients often describe peace of mind knowing they are protected from AFib-related strokes while avoiding the daily challenges of anticoagulation.
Take the Next Step Toward Better Heart Health
Untreated AFib significantly raises the risk of stroke, but procedures like Watchman give patients a safer, lasting option for prevention. If you or a loved one has AFib and struggles with blood thinner side effects or bleeding risks, ask your cardiologist if the Watchman procedure could offer a safer alternative. Taking the next step now can help protect your health and give you greater confidence in your future. Visit your local cardiology clinic or heart specialist for a consultation to discuss your options.
Considering Watchman in Houston?
If you’re in the Houston area, our electrophysiology team at CLS Health evaluates candidacy for the Watchman procedure and guides you through every step—from consultation to recovery.
Schedule an appointment online or visit our clinics in Houston and Webster to discuss whether left atrial appendage closure is right for you.